This invention relates to an orthopedic appliance that is designed to assist in the reduction of an anterior dislocation (sub coracoid dislocation) of a person's shoulder using what is known as the "Stimson Technique". Currently, hospitals and centers that provide medical assistance or treatment to persons involving dislocations of shoulders have turned to fixing weights of one type or another to a person's arm in order to achieve a downward pulling on the person's arm while they lay prone on a table or other surface. The maximum benefit of any weight utilized in this manner is realized by having the patient placed in a prone position on the edge of a table or gurney with the arm extending directly downwards. While the patient has weight pulling downward on their arm or hand, they are instructed to relax. The patients are expected to maintain this position for approximately ten to fifteen minutes, with muscle relaxation being a priority.
Hospitals and treatment facilities offering their services to injured persons have utilized weights anywhere from ten pounds up to twenty-five pounds, held by a person's hand to give the downward pull necessary to reduce the anterior dislocation. The weights that have been generally used have comprised such archaic methods as pails of water and dumbbells themselves that the person/patient is expected to hold. A bucket is used because the amount of weight can be varied proportionately to the volume of water placed into the bucket. The major drawback of such attempts has always been that the patient with the anterior dislocation is themselves forced to hold onto the weight, which can be a painful process to the patient, causing muscle relaxation to be more difficult to achieve.
Other methods such as providing traction to a person so that their arm is pulled upwards is shown and described in U.S. Pat. No. 4,616,637 (Caspari, et al.). This patent, which was issued in 1986, employs a forearm gripping device. The relevance of this prior art shows that a forearm can be wrapped with material to provide a means to grip the forearm while applying a pulling force. This particular device, however, had no means to direct the arm downwards and was more useful in simply holding an arm in an upward position during surgical procedures.
Various exercising devices exist, but which have not been readily utilized by medical treatment facilities. The common drawback for these existing exercising devices is the complexity of them and their inability to readily attach to an appendage concurrent with the inability to quickly and easily modify the amount of weight placed in the device or apparatus itself. U.S. Pat. No. 3,910,577 (Boyle) typifies a device which can be simply draped over a person's appendage containing pouches in which weights themselves may be placed therein. This would provide a resistance to upward movement to a person desiring to lift their leg or arm in an exercise maneuver. This particular device has little real use with the problem at hand in dealing with anterior dislocations, since there is no method for the Boyle device to be properly affixed to a person's arm for a direct downward pull on said arm.
Another device which was intended for use with a person's arm and hands in shown in U.S. Pat. No. 4,109,908 (Pugh, et al.). In Pugh, the user is required to grip a handle which stabilizes a weight holder platform that is strapped to a person's forearm on one end. While the device's benefits for exercising a person's forearms are evident, this particular device would still require a user to grip the handgrip and to maintain a continuing grip on said handgrip during the entire process in which a dislocation is being reduced. Since the purpose of a proper device is both to provide a downward pull while achieving relaxation of the patient, relaxation is once again unable to be fully achieved due to the person's need to utilize the forearm muscles to employ their fingers to grip the device.
A weighted cuff is depicted in U.S. Pat. No. 4,384,714 (Kimura). In Kimura, there is a thick plate-like main body that is formed that has a plurality of elongated holes which can receive weighted rods. The number of rods inserted in the receiving holes dictates the extent of weight being implied by the device to a person's appendage. This device has the drawback for being unable to provide sufficient amounts of weight to adequately reduce a person's anterior dislocation properly. The device shown in Kamura tends to be one that would simply make a person's movements during exercise more difficult, thereby increasing the stress on muscles being exercised and giving the user of this the benefit of an increased physical workout in a shorter period of time. A subsequent weighted exercise apparatus is shown in U.S. Pat. No. 4,858,916 (Beaumont). The Beaumont apparatus is similar to that shown in Pugh, et al., in that the user has a strap around their forearm with a means to grip and hold on to the apparatus itself utilizing a gripping bar. Weights may be incrementally added or reduced depending on the user's desire. This invention has the same limitations as does Pugh with regard to reducing anterior dislocations. This device has no means for the user to relax their forearm muscles, thereby allowing their fingers to relax as well. This device has the same drawbacks and problems as does using a bucket of water.
A weighted exercise glove is depicted and described in U.S. Pat. No. 4,368,883 (Tiktin). In Tiktin, the glove has attachment points by which the user may affix weights on various fingers. The glove itself is designed primarily to exercise individual fingers and muscles and corresponding muscles in a person's forearm. This device would have some difficulty in having sufficient weight attached to reduce an anterior dislocation, since a great deal of stress would be required to be placed on individual fingers, rather than on the more durable forearm bone structure.
A somewhat similar device to the Tiktin patent is shown in U.S. Pat. No. number 5,004,227 (Hoffman). In Hoffman, an exercise apparatus comprises a glove like apparatus in which the back of the hand and palm area provides support for attachment of weights which are affixed within a pocket in the glove. This device has the drawback of being unable to position the weights directly downward of the arm itself so that if sufficient weights were utilized in the pouch area of the Hoffman apparatus, the pull on the arm would be off center from the arm, and fail to provide a direct downward pull. In addition, the pull should be limited to the arm, rather than the wrist alone. To maximize reduction of an anterior dislocation, the weight must be positioned so that it is providing a direct, downward pulling force uniformly around the circumference of the arm itself, rather than weights being distributed on one external side and providing a pulling force on only one side.